Organization
R. DOUGLAS ROSS, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DOUGLAS ROSS DDS (OWNER)
(540) 344-9361
Entity
Organization
Contact information
Practice address
1602 GRANDIN RD SW, ROANOKE, VA 24015-2308
(540) 344-9361
(540) 344-9377
Mailing address
1602 GRANDIN RD SW, ROANOKE, VA 24015-2308
(540) 344-9361
(540) 344-9377
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401007069
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922141811
INDIVIDUAL NPI
VA
Enumeration date
07/02/2018
Last updated
07/02/2018
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